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Individual

STEPHEN BLAINE MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5187 US ROUTE 60 E, SUITE # 9, HUNTINGTON, WV 25705-2076
(304) 399-2222
(304) 399-2223
Mailing address
5187 US ROUTE 60 E, SUITE # 9, HUNTINGTON, WV 25705-2076
(304) 399-2222
(304) 399-2223

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
18744
WV
208200000X
Plastic Surgery Physician
81842
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001722820
BLUE CROSS
WV
01
066033492
AETNA
05
1000263000
WV
01
1057260
WV WORKER'S COMP
WV
01
240007609
RAILROAD MEDICARE
WV
Enumeration date
05/23/2006
Last updated
05/10/2013
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